<div class="container">
	<table>
		<tr>
			<td>
				<label class="searchformlabel" style="width:40%"><strong>Age(yrs.):</strong><%= history.get('age')%></label> 
				
			</td>
			<td>
				<label class="searchformlabel"><strong>Gender:</strong><%= history.get('gender')%></label>
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel" style="width:40%"><strong>Weight(kgs.):</strong><%= history.get('weight')%></label> 
			</td>
			<td>
				<label class="searchformlabel" style="width:40%"><strong>Height(cms.):</strong><%= history.get('height')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Marital Status:</strong><%= history.get('maritalStatus')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Smoking:</strong><%= history.get('smoking')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Drinking:</strong><%= history.get('drinking')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>High blood pressure:</strong><%= history.get('bp')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Heart disease:</strong><%= history.get('heart')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>High Cholesterol:</strong><%= history.get('cholestrol')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Diabetes:</strong><%= history.get('diabetes')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Kidney disease:</strong><%= history.get('kidney')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Asthma or Lung disease:</strong><%= history.get('asthma')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Tuberculosis:</strong><%= history.get('tb')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Liver disease or hepatitis:</strong><%= history.get('liver')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Arthritis:</strong><%= history.get('arthritis')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Bleeding disorder:</strong><%= history.get('bleeding')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>HIV:</strong><%= history.get('hiv')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Cancer:</strong><%= history.get('cancer')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Food Allergy:</strong><%= history.get('foodAllergy')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Food allergy details:</strong><%= history.get('foodAllergyDetail')%></label>
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Drug Allergy:</strong><%= history.get('drugAllergy')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Drug allergy details:</strong><%= history.get('drugAllergyDetail')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Chemical Allergy:</strong><%= history.get('chemicalAllergy')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Chemical allergy details:</strong><%= history.get('chemicalAllergyDetail')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Pencillin Allergy:</strong><%= history.get('pencillinAllergy')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Pencillin allergy details:</strong><%= history.get('pencillinAllergyDetail')%></label> 
			</td>
		</tr>
		<tr>
			<td>
				<label class="searchformlabel"><strong>Taking any medication?:</strong><%= history.get('medication')%></label> 
			</td>
			<td>
				<label class="searchformlabel"><strong>Medication Detail:</strong><%= history.get('medicationDetail')%></label> 
			</td>
		</tr>
	</table>
</div>